The Prevalence of Celiac Disease in the United States

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
The American Journal of Gastroenterology (Impact Factor: 10.76). 07/2012; 107(10):1538-44. DOI: 10.1038/ajg.2012.219
Source: PubMed


The prevalence of celiac disease (CD) in the United States is unknown. We sought to estimate CD prevalence nationwide by using a nationally representative sample.
This study included 7,798 persons aged 6 years or older who participated in the National Health and Nutrition Examination Survey 2009-2010. Serum samples from all participants were tested for immunoglobulin A (IgA) tissue transglutaminase antibodies and, if findings were abnormal, also for IgA endomysial antibodies. Information about prior diagnosis of CD and use of a gluten-free diet (GFD) was obtained by direct interview. CD was defined as having either double-positive serology (serologically diagnosed CD) or a reported diagnosis of CD by a doctor or other health-care professional and being on a GFD (reported clinical diagnosis of CD).
CD was found in 35 participants, 29 of whom were unaware of their diagnosis. Median age was 45 years (interquartile range, 23-66 years); 20 were women and 29 were non-Hispanic white. The prevalence of CD in the United States was 0.71% (95% confidence interval (CI), 0.58-0.86%), with 1.01% (95% CI, 0.78-1.31%) among non-Hispanic whites. In all, 55 participants reported following a GFD, which corresponded to a prevalence of 0.63% (95% CI, 0.36-1.07%).
The prevalence of CD in the United States was 0.71% (1 in 141), similar to that found in several European countries. However, most cases were undiagnosed. CD was rare among minority groups but affected 1% of non-Hispanic whites. Most persons who were following a GFD did not have a diagnosis of CD.

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    • "The first report about a syndrome caused by exposure to gluten in absence of CD dates back to 1978 [8] [9] [10], but for decades this clinical entity was set apart [2]. Actually, data from epidemiological studies reveal that patients refer to gastroenterologists and other specialists for a wide range of gluten-related symptoms, even in the absence of a definite diagnosis of CD or WA [11] [12] [13]. Moreover, in the last few years the self-prescription of GFD has emerged as a relevant phenomenon, apparently based on the perception of being a " healthier diet " [14] [15]. "
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    ABSTRACT: and Aim . Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods . During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results . A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions . Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.
    Full-text · Article · Dec 2015
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    • "Furthermore, in Finland, according to one report, the incidence of coeliac disease was 1.5% among children (Mäki et al ., 2003), 2% in adults and 2.7% in the elderly (Vilppula et al ., 2009). In the United States, the prevalence among the populace is about 1% (Alberto et al., 2012). As a result of the serological studies carried out in Australasia, Europe and South America, between 0.5 – 1% of the people in these countries carry the disease undetected (West et al., 2003;Fasano et al., 2003). "
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    ABSTRACT: The present study is to determine the prevalence and implication of coeliac disease (CD) among adult Saudis and compared to those with diagnosed irritable bowel syndrome. This prospective study was conducted among 980 adults. Out of that number, 482 subjects (staff and students of Riyadh Health Science College) were designated as control cohorts for undetected coeliac disease. Furthermore, another contingent of 498 subjects diagnosed of irritable bowel syndrome (IBS) at Prince Salman Hospital and Al- Iman General Hospital also constituted a segment of the overall initial 1020 subjectsBoth cases and control were tested for serological markers of coeliac disease (tissues transglutaminase (tTGAs) and endomysial autoantibody (EMAs) and was confirmed by histopathology test. All the positive for cases of coeliac disease were screened for iron deficiency anaemia, Vitamin D deficiency, and osteoporosis and weight assessment. The percentage of coeliac disease in control subjects and patients diagnosed with irritable bowel syndrome (IBS) were found to be 1.9% and 9.6% respectively, about 38% of the total coeliac disease patients are among females in middle age (20 – 39- years) and 16% of the males on the same age range. Whereas, 20% and 25% of all coeliac disease cases with ages of 40 -59 were remarked in females and males respectively. The identical nature and overlap of symptoms of the two conditions could possibly result in misdiagnosis of coeliac diseases or over-diagnosis of irritable bowel syndrome. The findings of the study might also give considerable in implications of the disease in nutritional level which also noticeable.
    Full-text · Article · May 2015 · Saudi Journal of Biological Sciences
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    • "Celiac disease is predominately a T cell-mediated immune disease caused by sensitivity to the dietary protein gluten. It is primarily a disease of Caucasians, with a population prevalence of approximately 1%[1]–[3]. The role of the major histocompatibility complex (MHC) in celiac disease was first reported 30 years ago [4], [5], with the identification of HLA-DQ2 almost 20 years ago [6]. "
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    ABSTRACT: We performed a genome-wide association study (GWAS) of 1550 North American celiac disease cases and 3084 controls. Twelve SNPs, distributed across four regions (3p21.31, 4q27, 6q15, 6q25), were significantly associated with disease (p-value <1.0×10-7), and a further seven SNPs, across four additional regions (1q24.3, 10p15.1, 6q22.31, 17q21.32) had suggestive evidence (1.0×10-7 < p-value < 1.0×10-6). This study replicated a previous suggestive association within FRMD4B (3p14.1), confirming it as a celiac disease locus. All four regions with significant associations and two regions with suggestive results (1q24.3, 10p15.1) were known disease loci. The 6q22.31 and 10p11.23 regions were not replicated. A total of 410 SNPs distributed across the eight significant and suggestive regions were tested for association with dermatitis herpetiformis and microscopic colitis. Preliminary, suggestive statistical evidence for association with the two traits was found at chromosomes 3p21.31, 6q15, 6q25, 1q24.3 and 10p11.23, with future studies being required to validate the reported associations.
    Full-text · Article · Jul 2014 · PLoS ONE
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